Build Evidence Base

Ensure Quality Implementation

Expansion of FDC Reach

National Family Drug Court Strategic PlanAdvancing the Movement 2017

Vision: Every family in the child welfare system affected by parental/caregiver substance use disorders will have timely access to

comprehensive and coordinated screening, assessment and service delivery for family’s success.

Visit: www.familydrugcourts.blogspot.com

Build Evidence Base

Ensure Quality Implementation

Expansion of FDC Reach

National FDC Strategic Plan

Advancing the Movement 2017

NADCP 2017 Sessions

• The Big 7 – Key Practices to an Effective FDC• Blueprint Guide for Building or Re-Designing Your FDC• How FDCs are Supporting Recovery and Reunification Using Milestones • Utilizing Parent Mentors in FDCs• Enhancing Accountability & Success Using Mandatory Approach• Effective Strategies to Engage Fathers in FDC• What Does Quality Treatment Look Like?

• Unique Adaptations of FDC & Family Tribal Healing to Wellness Courts• Transitioning to Family-Centered Approach – Lessons from Three ADCs• Planning for Safe Care: What FDC Need to Know about Opioid • Tompkins County (NY) Prevention and Family Recovery Initiative

• Moving Forward – Research, Reflections, and Roadmap for FDCs• Advancing the FDC Movement – National Strategic Plan and FDC

Standards

Build Evidence Base

Ensure Quality Implementation

Expansion of FDC Reach

National Family Drug Court Strategic PlanAdvancing the Movement 2017

WebinarWednesday, September 13th

@ 11:00 – 12:00 PM PST (2:00 – 3:00 PM EST)

The FDC Movement has come a long ways!Join us to hear the State of the Movement and

what you can do advance the vision to serve more children and families!

THE POWER OF PARTNERSHIP –TOMPKINS COUNTY PREVENTION AND FAMILY RECOVERY INITIATIVE

Theresa Lemus and Marianna Corona, Children and Family FuturesHonorable John Rowley, Judge, Tompkins County Family Treatment Court

Improving Family

OutcomesStrengthening Partnerships

Advancing the FDC Movement 2017 Acknowledgements

The Prevention and Family Recovery Project is generously

supported by:

The Doris Duke Charitable FoundationThe Duke Endowment

Learning Objectives

• Participants will better understand the key lessons learned from the first round of the Prevention and Family Recovery initiative

• Participants will understand one county’s innovative approach to serving families involved in child welfare and impacted by substance use

• Participants will better understand strategies Judges can use to help develop a new standard of care for Family Drug Court clients and ensure the services in the community meet the needs of participants

• Participants will be able to identify successes that can come from a strong partnership between the court and child welfare

• Participants will better understand common indicators that courts can monitor to determine the impact of program and policy changes

Lessons Learned from the First Round of Prevention and Family Recovery

Mission

The Prevention and Family Recovery (PFR) initiative seeks to demonstrate how a comprehensive family-

centered FDC approach—grounded in effective cross-systems collaboration and evidence-based

practices—improves child, parent and family outcomes, particularly in the areas of child abuse and

neglect, reunification and parent-child relationships.

PFR Round 1 Grantees

Tompkins County (Ithaca, NY)

Pima County (Pima, AZ)

Robeson County (Lumberton, NC)

San Francisco (San Francisco, CA)

Domains of Lessons Learned

Reiterate the need to stay true to and focused on fundamental FDC

best practices when expanding the FDC’s programmatic scope.

FDC Core Practices and Collaborative Capacity

(Lessons 1 – 4)

Underscore the challenges associated with developing the capacity to implement

evidence-based interventions within the FDC context and then ensuring that

families are connected to these service enhancements.

Evidence-Based Services Implementation and

Integration (Lessons 5 – 6)

Emphasize the need for FDCs to look beyond “project thinking” and apply an

understanding of how their initiatives fit into their larger systems and

communities.

Systems Change (Lessons 7 – 9)

1. Increased, renewed and continued focus on cross-system collaborative partnerships is needed to expand and sustain the FDC scope

2. The effectiveness of parenting and children’s services is integrally linked to timely, effective substance use disorder treatment

3. A formal governance structure is necessary to prioritize, oversee and sustain the FDC work

4. FDC Teams need to maintain a consistent and strong focus on FDC participant recruitment, timely engagement and retention

Reiterate the need to stay true to and focused on fundamental FDC

best practices when expanding the FDC’s programmatic scope.

FDC Core Practices and Collaborative Capacity

(Lessons 1 – 4)

5. Developing the “evidence-based practice capacity” is a complex undertaking

6. FDC teams need to build bridges to connect families to services and service providers to each other

Underscore the challenges associated with developing the capacity to

implement evidence-based interventions within the FDC context and then ensuring

that families are connected to these service enhancements.

Evidence-Based Services Implementation and

Integration (Lessons 5 – 6)

7. To integrate a truly family-centered FDC approach requires several paradigm shifts

8. Sustained and consistent evaluation and performance monitoring provides a continuous feedback loop needed to drive ongoing program improvement and systems change

9. To achieve larger systems change requires understanding and adapting to the changing contextual environment

Emphasize the need for FDCs to look beyond “project thinking” and apply an understanding of how their initiatives

fit into their larger systems and communities.

Systems Change (Lessons 7 – 9)

Parent Recovery & Child Needs (separately)

Joint Projects that achieve project

enhancements

Parent Recovery Only

Individual Projects

separate from the larger system

Family-Centered (parent-child relationship)

Systems Change Initiatives

driven by relationships, results, and resources

How PFR Is Achieving Change

Tompkins County Family Treatment CourtA Facilitated Discussion with Judge John Rowley

Tompkins County FTC Enrollment Criteria

• The Tompkins County FTC serves all families involved in child welfare where drug or alcohol abuse has been identified as a factor in the child welfare case

• From July 2015 – June 2016, Tompkins County Department of Social Services substantiated 138 cases of child abuse or neglect

• Of those 138 cases, 54 cases had drug or alcohol abuse identified as a factor in the determination. These 54 cases included 77 adults and 95 children

Lessons from Tompkins County

• Grow your Family Treatment Court Team

• Coordinate and track referrals to services

• Address team tension

• Train – within the team, outside the team, and across systems

• Use data to inform both program improvement and policy changes

Grow your Family Treatment Court Team

• Prior to the PFR initiative, who were the key partners on the FTC team?

• How did growing the team enhance services to families?

Strategies

• Added partners from mental health and public health

• Added liaisons to the courtroom to help address access to substance use disorder treatment and domestic violence advocacy

Coordinate and Track Referrals to Evidence-Based Parenting Programs

The Tompkins FTC added SafeCare and the Strengthening Families Program to support parents and children. Both interventions had early referral challenges.

Strategies• Added a Children’s

Services Liaison within the Department of Social Services to support coordination and tracking of referrals

• What were the initial barriers to referring families to the EBPs?

Address Team Tension

• What were some of the dynamics of the FTC team during the PFR initiative?

• Can you talk a bit about how you perceived this tension, from your position on the bench?

Strategies

• Recognize and talk about the tension

• Engage the FTC team in conflict resolution with an outside mediator

• Provide ongoing training to all members of the FTC team

Train – within the team, outside the team, and across systems

• Can you talk a bit about the trainings that have helped you support a more family-centered court?

• Can you talk a bit about how the FTC team used grounding techniques in staffing following the Seeking Safety training?

Strategies• Trainings for the Judge• Trainings for team

• Solution Focused Trauma Informed Care

• Motivational Interviewing• Seeking Safety

• Training for Community of Providers• Lunch and Learns• Seeking Safety• Plans to open EBP training to

community providers

Use Your Data – To Inform Program Improvement as well as Policy Change

• How did the FTC team use data to help improve the program?

• How did you find time to discuss data?

• How will this data help you as you move forward?

Strategies• Make discussion of data

part of ongoing FTC meetings

• Consider restructuring your staffing to make time for data informed decisions

• Utilize data to support sustainability

How Outcomes for Families Improved

Data from the Tompkins Family Treatment Court June 2017 Final PFR Report

Reduced Time in Out-of-Home Care

Time Period Trial Discharge Cases

Number of Children

Time In Care < =12 months

Percent <= 12 months

NOV 2013 – OCT 2014 9 13 5 38%

NOV 2014 – OCT 2015 17 25 17 68%

NOV 2015 – NOV 2016* 12 17 12 71%

DEC 2016 – MAY 2017** 14 24 14 58%

NOV 2014 – MAY 2017 43 66 43 65%

• Analysis of trial discharge data showed that the number of children returned home within twelve months has increased significantly since the implementation of the PFR project.

• This change has largely occurred because there has been more focus by DSS and FTC Team on safety vs. risk factor in decision making with regard to return home.

• Cumulative data from November 2014 through May 2017 shows that 65% of children in out-of-home placement were returned home within twelve months.

Data reported in Tompkins County FTC Final Report – June 2017* Time period includes November 2016

** Represents the last 6 months of the grant period

Reduction in Number of DSS Custody Placements

Time Period Number of New Children

Number of Children Placed in DSS

Custody

Percentage of Children Placed in

DSS Custody

NOV 2013 – OCT 2014 58 42 72%

NOV 2014 – OCT 2015 67 27 40%

NOV 2015 – NOV 2016* 66 25 38%

DEC 2016 – MAY 2017** 19 7 39%

NOV 2014 – MAY 2017 152 59 39%

• Since the onset of the PFR project there has been a reduction of the percentage of children placed in foster care (DSS Custody).

• A larger number of children have been placed with relative resources and in some cases, the children have been able to remain at home with a safety plan.

• The DSS caseworkers have placed more focus on working with families to find placements rather than foster care when there are identified safety concerns.

Data reported in Tompkins County FTC Final Report – June 2017* Time period includes November 2016

** Represents the last 6 months of the grant period

Increased Return Home of DSS Custody Placements

• Since the onset of the PFR project there has been a steady increase in the number of children who have achieved permanency through return home to parent.

• There has also has been a concomitant decrease in the number of children freed for adoption.

• These data indicate that the additional parenting children services and changes in team have helped to increase the number of children returned home rather than surrendered for adoption.

Data reported in Tompkins County FTC Final Report – June 2017

9

4

2

18

12

6

0

10

19

2

0

13

18

4

0

6

0

2

4

6

8

10

12

14

16

18

20

RETURN HOME RELEASE TO RELATIVE OWN RESPONSIBILITY FREED FOR ADOPTION

Permanency Outcomes for Foster Care Placements

2013-2014

2014-2015

2015-2016

2016-2017

Increased FTC GraduationReduced Surrenders

Data reported in Tompkins County FTC Final Report – June 2017

Graduates represent persons who both completed treatment and had their children returned homeArticle 6 represents permanent custody with a relative; transfers were cases discontinued with FTC and transferred to another FTC unit or jurisdictionSurrenders represent parents who voluntarily surrendered their parental rightsUnsuccessful discharges represent those persons who did not complete treatment or have custody of their child at case closing.

19%

10%11%

45%

15%

45%

8%

21%

16%14%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Graduate Article 6 Transfers Surrender Unsuccessful

FTC Outcome – Pre and Post PFR

2011-2013

2014-2017

How a Change in Culture Helped Ensure Sustainability

All PFR funded services will be sustained via available funding sources.• SafeCare

– Training was funded by the grant.– There are now 6 trained public health nurses with one trained as a coach to

support sustainability.– Will continue for FTC participants through DSS preventative services contract

and funding which enables DSS to receive 63% reimbursement.• Parent Child Services Coordinator

– Now a permanent full-time internal position at the Department of Social Services (DSS) within the FTC unit.

– This staff helps coordinate services and communication for all children involved in FTC cases.

– Response from community has been positive in that they now have one caseworker calling rather than 5 – 6 caseworkers reaching out.

How a Change in Culture Helped Ensure Sustainability

• Strengthening Families Program (SFP)– Will continue to be delivered by a partner agency via a DSS contract.– Will continue for FTC participants through DSS preventative services contract

and funding which enables DSS to receive 63% reimbursement.• Solution Focused Trauma Informed Care

– Annual trainings are planned to provide a refresher to team members and to help orient new team members to this approach.

– Sustained through funding added to the DSS training budget.• Community Dispute Resolution

– The FTC team plans to meet regularly with this external facilitator. They propose meeting quarterly.

– Sustained through funding added to the DSS training budget.

Questions?

For additional information please contact:

THERESA LEMUS M.B.A., B.S.N., L.A.D.C.Senior Program AssociateCHILDREN AND FAMILY FUTURES, INC.NATIONAL CENTER ON SUBSTANCE ABUSE ANDCHILD WELFARE (NCSACW)714-505-3525TLEMUS@CFFUTURES.ORG

HONORABLE JOHN C. ROWLEYCounty JudgeTOMPKINS COUNTY FAMILY TREATMENT COURTITHACA, NEW YORK607-216-6634JROWLEY@NYCOURTS.GOV